suela923@aol.com
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Can I bill for the venogram? It appears that it was needed...??????
Thanks!
Fluoroscopic guided left upper extremity PICC line repositioning. Left upper extremity central venogram
History: Malpositioned PICC line.
Technique: Timeout was performed. Skin over the left arm was prepped and draped sterilely. X-ray of the chest was obtained. Central venogram was performed. Wire and catheter could not be advanced centrally so the PICC line was cut to 33 cm and advanced to the left subclavian vein. Final AP view of the chest was obtained. Patient tolerated the procedure well with no complications.
Findings: Left arm PICC line projects over the left subclavian vein. Left subclavian venogram shows central occlusion of the central left subclavian vein. There is filling of the internal jugular vein and left internal mammary vein. Transthoracic collaterals are seen. The occlusion could not be traversed. 33 cm PICC line was advanced to the left subclavian vein. Patient tolerated the procedure well.
IMPRESSION:
Occluded central left subclavian vein with transthoracic collaterals.
Left arm PICC line placed in the left subclavian vein just peripheral to the central occlusion. Uses of the PICC line will be at the discretion of the physicians prescribing the antibiotics.
Thanks!
Fluoroscopic guided left upper extremity PICC line repositioning. Left upper extremity central venogram
History: Malpositioned PICC line.
Technique: Timeout was performed. Skin over the left arm was prepped and draped sterilely. X-ray of the chest was obtained. Central venogram was performed. Wire and catheter could not be advanced centrally so the PICC line was cut to 33 cm and advanced to the left subclavian vein. Final AP view of the chest was obtained. Patient tolerated the procedure well with no complications.
Findings: Left arm PICC line projects over the left subclavian vein. Left subclavian venogram shows central occlusion of the central left subclavian vein. There is filling of the internal jugular vein and left internal mammary vein. Transthoracic collaterals are seen. The occlusion could not be traversed. 33 cm PICC line was advanced to the left subclavian vein. Patient tolerated the procedure well.
IMPRESSION:
Occluded central left subclavian vein with transthoracic collaterals.
Left arm PICC line placed in the left subclavian vein just peripheral to the central occlusion. Uses of the PICC line will be at the discretion of the physicians prescribing the antibiotics.